Speaking at an RCGP fringe meeting at the party’s annual conference in Manchester, Mr Burnham said there would be more resources for primary care as part of a new single health and care service, but that would mean new ways of working for some GPs in integrated organisations.
His comments came after shadow chancellor Ed Balls told the conference Labour would ‘save the NHS from the Tories’ in its first budget.
‘We will repeal the NHS Bill and stop the creeping privatisation of the national health service,' Mr Balls added.
Labour pledges NHS funding rise
In his leader’s speech on Tuesday, Labour leader Ed Miliband is expected to commit the party to increasing overall NHS spending. The BBC has said Mr Miliband will reveal plans for a ‘mansion tax’, and the Guardian reports there will also be a tax on tobacco firms to fund the NHS.
Mr Burnham said financial mechanisms should incentivise supporting patients in their homes and communities which meant ‘putting in place the resources on the ground in general practice, in community services, to build one team around the person'.
But, he said, it would be wrong and unsustainable to find extra resources without asking for changes.
The current system, he said, is ‘bedevilled’ with division. ‘So we have to ask people to work differently. We are going to have to build one team around the person. When it comes to the care of older people, vulnerable people with ongoing needs, I think we should ask GPs to work differently, or make the offer for GPs to work differently.’
‘I am looking at a model of care where we ask every community in England to develop an integrated care organisation, and I can see a role for salaried GPs working within that organisation at the centre of a multi-disciplinary team. Not waiting for people to come to them, but actively monitoring the identified vulnerable population within a community, and calling down the team as necessary.’
Independent contractors to stay
But, he added: 'That isn't about saying you sweep away the independent contractor status, I'm not saying that. That model will still be appropriate for some. But it is about saying that this model of integrated care, within an integrated care organisation, it does make sense to bring forward different models of care for people who need ongoing support and have social care needs too.’
Mr Burnham said he was not saying the independent contractor model should be abolished, but offering GPs a new model of ‘working more fluidly across across the whole health and care spectrum’, which may be ‘attractive to some younger people who don't want to make an investment in bricks and mortar’.
GPs should be empowered to prescribe social as well as medical help, Mr Burnham said, with immediate access to funded, structured social help, such as housing, employment or relationship advice to create a more holistic approach which would move from managing synonyms to helping people 'regain fundamental control' as well as relieving pressure on practices.
On his guarantee that patients will have access to GP services within 48 hours, he said: ‘We can't ask GPs do that without putting the support in to make that possible. But we will do that, because it's the right thing to do. It is part of a truly preventative NHS, and in the end it gets you towards the model of care I am advocating, which is whole-person care.'
Asked what one thing he would do to improve general practice, Mr Burnham said: ‘It is recruit more GPs. We have said, we need to improve GP recruitment as part of our commitment on 48 hours.’
Mr Burnham repeated his commitments to abolish the 2012 Health and Social Care Act, exempt the NHS from TTIP and make public NHS organisations prefered providers for NHS services.
GPC deputy chairman Dr Richard Vautrey challenged Mr Burnham not to conflate integration with abandoning independent contractor status.
‘Much of what you said will really resonate with most of the medical profession,’ Dr Vautrey told Mr Burnham. ‘They want to get rid of the health and social care act, the TTIP issue is really important, integration, yes, lots of people will welcome that. But please don't conflate that with the independent contractor status because you will start to lose people.’
He said practices were able to group and work together while remaining independent contractors, and GPs were 'desperate to co-operate and engage and participate with groups based around a practice', but they could do that without losing independent contractor status which was a 'bedrock' of the NHS.
Investment in general practice
RCGP chairwoman Dr Maureen Baker said she agreed that GPs could work together to deliver person-centred integrated care ‘without necessarily having salaried GPs employed by integrated care organisations'. She added: 'Not to rule it out. But we certainly don't believe that should be the only model.'
Dr Baker said she was ‘absolutely thrilled’ to hear Mr Burnham recognise the underinvestment and the ‘need for the pendulum to swing back to community and primary care’, and said GPs recognised the need for change.
‘We are not looking for resource for more of the same. We are looking for resources for a 21st century service for patients. We do need to change, and so does the rest of the NHS, so my colleagues are up for that.’